Organization
BETHANY CHRISTIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE JO CARLTON LLMSW (THERAPIST)
(616) 224-7617
Entity
Organization
Contact information
Practice address
901 EASTERN AVE NE, GRAND RAPIDS, MI 49503-1201
(616) 224-7617
Mailing address
901 EASTERN AVE NE, GRAND RAPIDS, MI 49503-1201
(616) 224-7617
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
6801091422
MI
251S00000X
Community/Behavioral Health Agency
Primary
6801091422
MI
Other
Enumeration date
07/22/2009
Last updated
07/22/2009
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